Provider Demographics
NPI:1720350879
Name:JCAS2, INC.
Entity type:Organization
Organization Name:JCAS2, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JOE
Authorized Official - Last Name:CRUM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:501-581-3711
Mailing Address - Street 1:PO BOX 1142
Mailing Address - Street 2:
Mailing Address - City:GREENBRIER
Mailing Address - State:AR
Mailing Address - Zip Code:72058-1142
Mailing Address - Country:US
Mailing Address - Phone:501-581-3711
Mailing Address - Fax:501-679-3711
Practice Address - Street 1:14300 CANTRELL RD STE 10
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-4216
Practice Address - Country:US
Practice Address - Phone:501-581-3711
Practice Address - Fax:501-679-3711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-06
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR15973111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty